Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-02-05
- Stop
- 2014-02-05
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
046903bc-0773-63cf-ae1d-7ee0c53faa05